Objective To determine the interleukin(IL)-17 concentrations in serum and synovi-al fluid from patients with knee osteoarthritis(OA),and evaluate their correlation with disease severity. Methods Serum and synovial fluid were collected from 100 patients with primary knee OA;age-and sex-matched 50 healthy subjects provided serum samples as controls.OA severity and grade were assessed u-sing the Lequesne index and Kellgren and Lawrence(K-L)grading system,respectively.The expression of IL-17 was quantified by enzyme-linked immunosorbent assay.Results Serum IL-17 concentrations were significantly higher in patients than in controls(P <0.05).In the patient group,patients with K-L grade 3 and 4 had higher synovial IL-17 levels than those with K-L grade 2(P <0.05).At the same time,com-pared with K-L grade 3,there was a higher IL-17 level in K-L grade 4 patients(P <0.05).Synovial fluid IL-17 concentration was positively correlated with Lequesne index(r =0.6232,P <0.05).There was no correlation between serum IL-17 concentrations and Lequesne index,however.Conclusion The expres-sion of IL-17 was significantly increased in serum and synovial fluid of knee from patients with knee OA. There was a positive correlation between synovial fluid IL-17 concentrations and OA severity.It suggests that the imbalance of IL-17 expression plays a certain role in the pathogenesis of OA.

Medial collateral ligament injury is the most common injury of the knee ligament. Most patients with conservative treatment can achieve preinjury activity level. Nonetheless,it's necessary to eval-uate the severity of the injury and judge the best time and details for surgery as serious injury of the medial collateral ligament will cause chronic knee stability and accelerate its degeneration. This paper summarizes the current status of diagnosis and treatment for medial collateral ligament injury of the knee,aiming to pro-vide guidance for dealing with this lesion.

Objective To explore the effects of different types of passive and active movements of foot and ankle on the venous return in the lower limb in order to provide evidence for prevention of venous stasis and deep- vein thrombosis(DVT)after joint replacement. Methods Peak and average velocities of the femoral vein were detected and measured by using color ultrasound Doppler on 30 limbs in 15 healthy volunteers under the circumstance of resting and different types of passive and active movements of foot and ankle. Results During the passive movements of the flexion and extension, inversion and eversion, and the circumduction of foot and ankle, the flexion and extension as well as the inversion and eversion only slightly increased the velocities of venous blood flow. The circumduction produced a higher increase in venous blood flow than the former two movements, increasing the peak velocity by 31.3％ and average velocity by 33.9％ . In the same 3 types of the active movements of foot and ankle, the active flexion and extension, inversion and eversion resulted in increases in peak velocity of 41.3％ and 32.9％ and in average velocity of 40.1％ and 32.4％ , respectively. The active circumduction of foot and ankle produced the strongest influence on the promotion of venous blood flow with the peak velocity increased by 69.3％ and average velocity by 69.1％ . Conclusion The active circumduction, flexion and extension, inversion and eversion, and the passive circumduction of foot and ankle can be utilized to prevent DVT after joint replacement. The active circumduction of foot and ankle is the optimal exercise to prevent DVT.

[Objective]To explore the therapeutic effects of angelica and sodium ferulate (SF) on experimental osteoarthritis and the related mechanisms in rats. [Method]Animal models of osteoarthritis were established in 40 rats by intra-articular injection of 4% papain. The rats were divided into five groups-model control group,25% and 5% angelica treatment groups, 0.5% and 0.1% SF treatment groups.Another additional 8 rats were used as normal control. Bilateral knees of the animalsin the treatment groups began receiving intra-articular injection of 0.1ml angelica injection or SF of corresponding concentration respectively every 3 days while those of the animals in the control groups received saline. All the animals were sacrificed 6 weeks later and samples of the cartilage, plasma and synovial fluid were taken. The contents of MDA and the activities of SOD in the plasma and synovial fluid were detected.Histological examinations of the cartilage were performed and immunohistochemical analyses for MMP-1, TIMP-1, Bcl-2 and Bax in the cartilage were done.[Result]25% Angelica and 0.5% SF significantly decreased the levels of MDA in both plasma and synovial fluid (P

Objective To detect type Ⅱ collagen synthesis by cultured human chondrocytes under the influence of different intermittent fluid shearing forces.Methods Second passage human monolayer chondrocytes were divided into low-speed (20 rpm/min), mid-speed (40 rpm/min) and high-speed (60 rpm/min) groups according to the rotation speed of the rocking bed. The expression of type Ⅱ collagen was analyzed using immunohistochemistry and RT-PCRs.Results The absorbance of the mid-speed and high-speed groups was significantly greater than that of the low-speed group and a control group. The average optical density of type Ⅱ collagen by RT-PCR was significantly higher in all three sheared groups than in the control group.Conclusions Intermittent shearing can enhance cellular proliferation and the metabolism of human chondrocytes in vitro and promote the expression of type Ⅱ collagen.

BACKGROUND:Basic fibroblast growth factor (bFGF) plays an important role in the ligament tissue healing process, and bone marrow mesenchymal stem cel s transfected with growth factors can be used as seed cel s in ligament tissue engineering.
OBJECTIVE:To observe biological effect of bone marrow mesenchymal stem cel s transfected with recombinant adenovirus vectors carrying bFGF in three-dimensional co-culture with ligament fibroblasts.
METHODS:Passage 3 bone marrow mesenchymal stem cel s were divided into three groups:control group, Ad-EGFP group and Ad-bFGF group. Under a phase contrast microscope, the changes in cel morphology were observed and the rate of transfection was analyzed by flow cytometry. Proliferation of bone marrow mesenchymal stem cel s and ligament fibroblasts was analyzed by MTS, the expression of bFGF protein in bone marrow mesenchymal stem cel s was determined by ELISA. Scleraxis, col agen type I, col agen type III, decorin and cartilage oligomeric matrix protein levels were detected in BMSCs and ligament fibroblasts using real-time fluorescent quantitative PCR.
RESULTS AND CONCLUSION:Recombinant adenovirus-mediated bFGF gene could transfect bone marrow mesenchymal stem cel s efficiently. After co-culture for 3, 6 days, compared with the control group and Ad-EGFP group, in the Ad-bFGF group, the proliferation ability of bone marrow mesenchymal stem cel s and ligament fibroblasts was enhanced (P<0.01), the expression of bFGF protein in supernatant was obviously higher (P<0.01), the col agen type I, col agen type III, decorin and cartilage oligomeric matrix protein mRNA expression decreased in the ligament fibroblasts (P<0.01), but the mRNA expression of Scleraxis, col agen type I, col agen type III in bone marrow mesenchymal stem cel s increased (P<0.01). The results suggest that the co-culture of Ad-bFGF-transfected bone marrow mesenchymal stem cel s with ligament fibroblasts promotes the proliferation of ligament fibroblasts while decreases the col agen synthesis at the same time, and stimulates the proliferation and differentiation of bone marrow mesenchymal stem cel s into ligament fibrolasts.

Objective To investigate the effect of recombinant adenovirus-mediated basic fibroblast growth factor (bFGF),interleukin-1 receptor antagonist protein (IL-Ra) and insulin-like growth factor(IGF)-1 gene transfection on human osteoarthritis chondrocytes.Methods Monolayer cultures of human osteoarthritis chondrocytes were transfected with recombinant adenovirus carrying genes encoding the following cytokines: human bFGF,IL-1Ra and IGF-1.Six days later,levels of gene expression and glycosaminoglycan (GAG) in culture supernatant were detected.The proliferation and apoptosis of chondrocytes were analyzed by methyl thiazolyl tetrazolium (MTT) and flow cytometry respectively.Matrix biosynthesis was observed by toluidine blue staining and immunohistochemistry examination of type Ⅱ collagen.The expression of type Ⅱ collagen,MMP-3 and TIMP-1 were analyzed by immunoblotting.Comparisons between groups were performed with one-way ANOVA analysis.Results The expression of all transgenes was high following adenoviral transfection compared with the OA control group (P<0.05).The delivery of bFGF alone promoted the cell proliferation and resulted in a significant enhanced biosynthesis of type Ⅱ collagen and proteoglycans of chondrocytes (P<0.05).Compared with bFGF transfection alone,as two or three of the genes were transfected in different combinations,apoptosis rate of chondrocytes was decreased [(26.1±1.6)%,(19.4±1.0)%.(18.4±1.1)%,(13.9±1.8)%.respectively P<0.05].There was marked enhancement of matrix synthesis and expression of TIMP-1.At the same time,the expression of MMP-3 was inhibited.Conciuslon The bFGF gene transfection mediated with adenoviral vectors can greatly promote cell proliferation and increase matrix synthesis in vitro. Compared to the expression of bFGF alone, concomitant gene transfection of bFGF, IL-IRa and IGF-1 in different combinations plays a complementary role, further enhances matrix synthesis and inhibits matrix degradation.

In the present research, the effects of sintered bone modified with surface mineralization/P24 peptide composite biomaterials on the adhesion, proliferation and osteodifferentiation of MC3T3-E1 cells were investigated. The experiments were divided into three groups due to biomaterials used: Group A (composite materials of sintered bone modified with surface mineralization and P24, a peptide of bone morphogenetic protein-2); Group B (sintered bone modified with surface mineralization) and Group C (sintered bone only). The three groups were observed by scanning electron microscopy (SEM) before the experiments, respectively. Then MC3T3-E1 cells were cultured on the surfaces of the three kinds of material, respectively. The cell adhesion rate was assessed by precipitation method. The proliferative ability of MC3T3-E1 cells were measured with MTT assay. And the ALP staining and measurement of alkaline phosphatase (ALP) activity were performed to assess the differentiation of cells into osteoblasts. The SEM results showed that the materials in the three groups retained the natural pore structure and the pore sizes were in the range between 200-850 μm. The adhesive ratio measurements and MTT assay suggested that adhesion and proliferation of MC3T3-E1 cells in Group A were much higher than those in Group B and Group C (P < 0.05). The ALP staining and ALP activity of MC3T3-E1 cells in Group A were significantly higher than those in Group B and Group C (P < 0.05). The sintered bone modified with surface mineralization/P24 composite material was confirmed to improve the adhesion rate and proliferation and osteodifferentiation of MC3T3-E1 cells, and maintained their morphology.
3T3 Cells ; Animals ; Biocompatible Materials ; Bone Morphogenetic Protein 2 ; Bone and Bones ; Cell Adhesion ; Cell Differentiation ; Mice ; Microscopy, Electron, Scanning ; Osteoblasts ; cytology ; Peptides ; Staining and Labeling

Objective To compare the bone mineral density of the regions of femoral and tibial tunnels for anterior cruciate ligament(ACL)reconstruction in order to provide reference for the choice of optimal screw diameter for interference fixation.Methods Thirty healthy volunteers aged from 18 to 35 years were enrolled in our study,and the dual-energy X-ray absorptiometry(DEXA)was used to measure the bone mineral density of femoral and tibial tunnel regions of the right knee.All the right knees of the volunteers were also scanned by spiral CT and three-dimensional reconstruction technique was utilized to determine the circular sections that pass through the longitudinal axis of the femoral and tibial tunnels separately.The CT gray scale values of the Sections were measured.From August to October 2010,9 patients who had been diagnosed as ACL rupture underwent the operation of ACL reconstruction,and cylindrical cancellous bone peg was removed from the femoral and tibial tunnel respectively during the operation.Volumetric bone mineral density of the bone pegs were measured by using a standardized immersion technique according to Archimedes’ principle.Results Measured by DEXA,bone density of the femoral tunnel region arid tibial tunnel region were(1.162±0.034)g/cm2 and(0.814±0.038)g/cm2 respectively.The difference was significant between the femoral and tibial tunnel region(t=9.11,P=0.000).The CT gray scale value of the section for femoral tunnel region was(211.7±11.5)Hu,while that of the tibial tunnel region was(104.9±7.4)Hu.There was statistically significant difference between them(t=10.15,P=0.000).The volumetric bone mineral density of the bone peg from femoral tunnel and tibial tunnel were(2.80±0.88)g/cm3 and(1.88±0.59)g/cm3 respectively.The difference was statistically significant(t=4.32,P=0.002).Conclusion For ACL reconstruction,bone mineral density of femoral tunnel region is higher than that of the tibial tunnel.

Objective To investigate the hidden blood loss of intertrochanteric fractures in different gender. Methods Data of 108 patients with intertrochanteric fractures who were admitted to the department of orthopaedics from January 2012 to De?cember 2015 were retrospectively analyzed. For all patients who were composed of 42 males and 66 females and whose ages ranged from 32 to 95 years old, the average age was 75.4±10.8 years old. With the equation of Gross, the amount of perioperative hidden blood loss (PHBL) was calculated as well as the fraction of PHBL. The lineal regression model was utilized to analyze the correlations between PHBL and those factors including age, time interval between injury and surgery, injured side, Evans classifi?cation of intertrochanteric fractures, patients' ASA grade, and type of anesthesia. The difference of hemoglobin (Hb), hematocrit (Hct), total blood volume, the amount of PHBL, and the percentage of PHBL were respectively compared between male group and female group. Results PHBL had no correlation of lineal regression with age, time interval between injury and surgery, injured side, Evans classification of intertrochanteric fractures, patients' ASA grade, or the type of anesthesia. The share of PHBL did not have correlation of lineal regression with age, time interval between injury and surgery, injured side, Evans classification of inter?trochanteric fractures, patients' ASA grade, or the type of anesthesia as well. Lineal regressive correlation only existed between gender factor and the PHBL fraction of total blood volume, and there was no regressive correlation between gender factor and the amount of PHBL. In the male group, the mean amount of preoperative Hb was 121.8±16.6 g/L and preoperative Hct was averagely 36.7%±5.0%;in the female group, the amount of preoperative Hb was 99.5±13.1 g/L on average and the mean amount of Hct was preoperatively 30.6%± 3.7%. Postoperatively, the mean amount of preoperative Hb was 103.4 ± 19.3 g/L and Hct was averagely 29.8%±4.2%;in the female group, the amount of postoperative Hb was 79.0±10.4 g/L on average and the mean amount of Hct was postoperatively 23.9%± 2.6%. Significant difference of perioperative Hb and Hct was found between two groups. The total blood volume was averagely 4 500.6±191.5 ml in the male group and 3 607.0±235.7 ml in the females group. There was statistical differ?ence between two groups. For male group, the amount of PHBL was 647.9±174.1 ml on average and accounted for 14.4%±4.0%of total blood volume. For the female group, the mean amount of PHBL was 694.8±216.5 ml and making up 19.3%±6.1%of the total blood volume. As for the amount of PHBL, no significant difference was observed between male group and female group, but there was statistical difference of the share of PHBL accounting for total blood volume between two groups. Conclusion Female pa?tients' PHBL fraction of total blood volume is greater than male patients', therefore females' PHBL conditions need to be paid more attention to and ought to be corrected in time.